Influence of mouthwashes on extended exhaled nitric oxide (F_ENO) analysis

Figures & data

Table 1. Demographic, anthropometric and spirometric data of the study participants.

	n	Mean (SD)	Range	Spirometry	n	Mean (SD)	Range
Age (years)	30	43 (14)	16–68	FVC (l)	25	4.1 (1.1)	2.65–6.69
Height (cm)	30	171 (8)	157–186	FVC (%^a)	25	93 (16)	50–120
Weight (kg)	30	73 (15)	49–109	FEV1 (l)	25	3.3 (0.9)	2.06–5.36
Female/male	17/13	57%/43%		FEV1 (%^a)	25	93 (16)	50–117
Asthma	6	21%		FEV1/FVC ratio	25	0.80 (0.1)	0.69–0.98
Allergic rhinitis	9	31%		FEV1/FVC (%^a)	25	98 (7)	88–125
Smoking	2	7%
COPD	1	3%

Data presented as mean (SD) or percentage of total case number.

^aPercentage of predicted value (predicted according to Viljanen et al. [25]).

Figure 1. Flowchart illustrating the procedures, mouthwashes and repetitions performed during one day. Tap: tap water mouthwash, carbonated: carbonated water mouthwash.

Figure 2. F_ENO measured at multiple expiratory flow levels after different mouthwashes. Pairs compared with the Wilcoxon signed-rank test.

Figure 3. Individual F_ENO values measured at multiple expiratory flow levels after different mouthwashes. Ordinate represents the individuals (n = 30), abscissa represents F_ENO (ppb) at multiple expiratory flow levels after: carbonated water mouthwash (black dots), and tap water mouthwash (grey rhombi). Abscissa truncated at 75 ppb. Subjects 1 and 2 had higher F_ENO (ppb) values (not shown). The missing higher values (tap water/carbonated) for subject 1 are: 128/128, 85/79; and for subject 2 are: 311/322, 222/208, 117/117.

Table 2. Summarized results of F_ENO at every flow rate and mouthwash either with tap water or carbonated water.

FENO (ppb)	Median	MAD	IQR	p^a	Mean (SD)	Difference^b	Mean cv^c
Flow 30 mL/s, tap water	22.86	10.11	20.4	.001	39.21(57.04)	–4.6%	8.6 (4.5)
Flow 30 mL/s, carbonated water	20.11	9.49	20.7		37.40(59.28)		7.3 (5.0)
Flow 50 mL/s, tap water	14.94	6.76	13.3	<.001	27.27(40.19)	–6.4%	8.4 (6.2)
Flow 50 mL/s, carbonated water	14.91	7.24	14.4		25.51(38.01)		6.6 (3.9)
Flow 100 mL/s, tap water	9.03	3.91	8.8	<.001	15.41(21.58)	–4.4%	7.0 (6.6)
Flow 100 mL/s, carbonated water	8.15	3.68	8.7		14.74(21.72)		6.1 (4.0)
Flow 300 mL/s, tap water	3.84	1.36	3.2	.004	6.03(7.29)	–4.2%	6.9 (4.1)
Flow 300 mL/s, carbonated water	3.53	1.31	3.0		5.77(7.45)		8.0 (5.3)

Data presented as median, median absolute deviation (MAD), interquantile range (IQR), n = 30. Mean c_v calculated from individual c_v of F_ENO (consisting of at least four valid F_ENO results for each flow rate and mouthwash).

^aWilcoxon’s signed ranks test.

^bRelative decrease of the mean.

^cPresented as mean (SD) in percent.

Table 3. Results of J′_awNO, C_ANO and D_awNO, after carbonated water or tap water mouthwash.

	J′awNO (pL/s)	p^a	CANO (ppb)	p^a	DawNO (pL·s^–1·ppb^–1)	p^a
Tap water	836.36 (457.58)	.015	0.88 (0.48)	.715	14.19 (7.52)	.299
Carbonated water	829.97 (443.12)		0.92 (0.33)		18.60 (3.87)
Tap water^b	796.88 (449.86)	<.001	1.00 (0.39)	.598	15.63 (6.95)	.871
Carbonated water^b	724.96 (392.60)		1.04 (0.30)		15.28 (3.67)

Data presented as median (median absolute deviation), n = 30.

^aWilcoxon’s signed ranks test.

^bCalculated with Högman and Meriläinen algorithm.

Viljanen AA, Halttunen PK, Kreus KE, et al. Spirometric studies in non-smoking, healthy adults. Scand J Clin Lab Investig. 1982;42:5–20.

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